Four Reasons to Change the Image of Eating Disorders

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Eating Disorders suffer from an “image problem”: they are frequently believed to affect only white females and to be a function of choice and vanity. These persistent myths have dangerous consequences for diagnosis, treatment, and research of these life-threatening illnesses. Current research shows eating disorders to be complex and multifactorial with strong genetic and biological components; they are triggered by a period of negative energy balance that may be either intentional or unintentional.

Regardless of how they start, an eating disorder is a serious medical crisis requiring significant intervention.

It can be difficult to get a timely eating disorder diagnosis even if one fits neatly into the young, affluent, female teen stereotype. For sufferers who can’t tick each of the above prototypical boxes, the delays involved can mean the disorder becomes entrenched and harder or impossible to treat – remember, early intervention is the best predictor of long-term recovery without lifelong health consequences. Non-female individuals and those from non-white backgrounds are usually diagnosed later in the course of the illness and thus have worse prognoses when it comes to recovery.

In this NPR piece, Stephanie Covington Armstrong discusses how the stereotype that black women don’t get eating disorders kept her in denial and from accessing help. Gloria Lucas said in an interview, “I struggled with an eating disorder in my late teenage years.

During that time, I never saw someone like myself, a brown Xicana woman, talking about having an eating disorder. The media always disseminated the same image: a white, middle-class girl with anorexia.” In her blog Sovereign Bodies, Sheena Roetman echoes this sentiment: “When most people think about eating disorders, they most likely conjure up a very specific image—a thin, white, upper-class woman.

After all, eating disorders have been considered a ‘rich girl’s disease’ for quite some time.”

Dagan VanDemark of Trans Folx Fighting Eating Disorders writes compellingly on the pervasive issues of anyone who doesn’t fit the aforementioned archetype and the high cost of medical and societal ignorance for all those who fall outside the assumed norm. Male activists Brian Cuban, Andrew Whalen and Sam Thomas work diligently to ensure doctors and society know that men get eating disorders too and members of the binge eating community are working to expand thinking about eating disorders as diagnoses outside the realm of anorexia nervosa and bulimia nervosa.

Why is it so important to change the image of eating disorders?

  1. Early intervention is as important to the health outcome of someone with an eating disorder as it is to someone with cancer. Far too few medical professionals realize that eating disorders have the highest mortality rate of any mental illness and that immediate, intense intervention is the best hope for a good outcome.
  1. Once diagnosed, accessing treatment is another tremendous hurdle. Eating disorder treatment has a history of largely catering to the traditionally diagnosed population; expensive residential treatment was developed to fit the affluent, white female demographic, to the exclusion of more affordable, inclusive, and accessible community-based programs.
  2. Public health programs and public insurance plans are less likely to address eating disorders because it is assumed that anyone with an eating disorder has access to private insurance and can afford expensive treatment. This further limits the availability of affordable treatment options for individuals of marginalized groups who commonly lack funds and insurance. It may be hard to get eating disorders on the national agenda when they are widely assumed to only affect this select group.
  3. Finally, because eating disorders are commonly seen as a luxury for affluent white teenage girls, there is less funding for treatment or research of eating disorders than other similar illnesses. In fact, Alzheimer’s disease gets approximately 95 times the research funding per person that eating disorders do. It will continue to be hard to get eating disorders on the national agenda, with a groundswell of support for finding answers, when they are widely assumed to affect only a select and well-resourced group.

In the larger eating disorder community, including clinicians, treatment centers and advocates, there are ways the destructive status quo is maintained. This includes providing visuals and stories for eating disorder websites, articles, blog posts and awareness pieces that primarily feature thin white women and girls. Choosing speaking lineups for conferences and events that do not actively push back against the white affluent female stereotype is both common and a missed opportunity to educate and inform in a powerful way. Research often neglects more diverse subjects and fails to acknowledge narratives of marginalized individuals and diverse paths to recovery. 

The way to achieve the field-wide common goals of early diagnosis, access to treatment and research funding parity is to ensure that all are aware eating disorders are an equal opportunity scourge. They are present in, and a risk to, all families and communities. It is only through united, concerted and continuing efforts that we can together change the face of eating disorders and overcome the current image problem. 

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